Healthcare Provider Details

I. General information

NPI: 1245316314
Provider Name (Legal Business Name): NATHAN H THUMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 PINE BREEZE DR
ANGWIN CA
94508-9620
US

IV. Provider business mailing address

1030 MAIN ST STE 210
SAINT HELENA CA
94574-2056
US

V. Phone/Fax

Practice location:
  • Phone: 707-965-2461
  • Fax: 707-965-2700
Mailing address:
  • Phone: 707-963-3696
  • Fax: 707-963-3697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG58451
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: